Self-help is a way to deal with problems that everyone faces from time
to time in their lives--illness, divorce, the death of a loved one, emotional
upsets or strains. Talking over these problems with other people who have
lived through them can help us cope with today's difficulties and help us
learn how to deal with tomorrow.

In the past two decades, the self-help movement has mushroomed. AA, the
largest self-help group, reports over one million members in the US. One
estimate places the total number of people in self-help support groups at 20
million. There are groups for addictions--Alcoholics Anonymous, Gamblers
Anonymous, Debtors Anonymous; for families--Families of the Mentally Ill,
Mothers of Twins Clubs, Tough Love; for illness/disability--National
Association of People with AIDS, Us Too (prostate), Tourette Syndrome
Association; for mental illness--Emotions Anonymous, Recovery, Inc., GROW; for
bereavement--The Compassionate Friends, Survivors of Suicide, Widow to Widow;
and for lifestyles--Single Mothers by Choice and Society for the Second Self (crossdressers).

Helping is at the center of all this activity: knowing how to receive
help, give help and help yourself. Underlying self-help is the basic theme:
"You are not alone." Self-help group members:

feel less isolated knowing others share similar problems;

exchange ideas and effective ways to cope with problems;

actively work on their attitudes and behavior to make positive
changes in their lives;

gain a new sense of control over their lives.

The knowledge base of self-help mutual support groups is experiential,
indigenous, and rooted in the wisdom that comes from struggling with problems
in concrete, shared ways. Self-help groups build on the strengths of their
members.

National Self-Help Clearinghouse

An Interview with
Frank Riessman, Executive Director

Frank Riessman has been a leader in the self-help movement for 35 years.
He is himself a member of a Parkinson's group. His books and articles on the
nature of mutual aid include The Self Help Revolution, Edited with Alan
Gartner, (NY: Human Sciences Press, 1984), Self-Help and the Human Services
with Alan Gartner (San Francisco: Jossey Bass 1979) and most recently
Redefining Self-Help with David Carroll (Jossey Bass, 1995). I spoke with him
recently about his work and the state of the movement today.

Erik Banks: You
have an unusually broad notion of self-help, which may surprise people who only
think of mutual aid groups like Alcoholics Anonymous and other Twelve Step
groups.

Frank Riessman: For me, self-help includes all of the practices people have
developed for dealing with their problems (drug abuse, emotional problems,
health and social problems) based on experience, ingenuity, indigenous
approaches like sharing stories and common experiences...It is the direct
opposite of external, professional "social engineering."

EB: Can you give us some examples?

FR: You have individual self-help. That means reading self-help books, quitting
smoking on your own or with a technique. Then there is group self-help or mutual
aid. Finally there is even community self-help (place-based). That's the kind of
self-help advocated by some prominent African American leaders for years. And
let's not forget about economic self-help, such as the lending circles started
by the Grameen bank of Bangladesh, which arranges loans for circles of women in
poor villages, who stand for each other as collateral for the loan.

EB: What would you say to those who think self-help is too individualistic and
self-involved?

FR: Individual self-help is confusing because it is seen as self-centered. Even
the term self-help is misleading. Let me give you my version. Individual
self-help can be equivalent to self-help or it can be something else. The
crucial distinction is whether the help is internally or externally generated.
Internal help of any kind is self-help. External help from professionals,
agencies and experts is something else. My intention is to define self-help as
anything that includes such internal approaches and eschews external
intervention. I have devoted much of my life to understanding the basis for all
of the forms in which this approach can be applied to human problems.

EB: Would everybody you identify as involved in the self-help movement identify
themselves that way? For example African American community self-help and
Alcoholics Anonymous?

FR: Not at all. A good example is AA: they don't even say they are self-help.
Many people tell me I am overdoing the comparison. I try to identify some key
values or features to help me decide what falls under the rubric of self-help. I
have boiled these down to a handful. First the internality I mentioned:
self-help programs rely on their own members and their experiences rather than
external help. Second: people benefit from self-help not so much by being helped
by others, but by providing help to others, as sponsors and mentors themselves.
That was a really surprising result of my research at first, but when you think
about it it makes sense, we are helped most by being a helper. I also think that
self-help is successful because it doesn't label people as problems but builds
on the strengths they do possess. Everyone's input is valued equally--there is
no head person with more authority than the others. If I participate in an
exercise and diet self-help group to improve my heart condition with like
individuals, self-determination is immediate. In a subtle way this represents an
extension of democracy to the way services are provided. I think that's really
encouraging and the helping professions could use more of it.

EB: How many people would you say are involved in the self-help movement as you
define it?

FR: Well we know for a fact that there are 56 million people have had some
involvement in mutual aid alone, over the course of a lifetime. You can add on
to that.

EB: If so many people are involved why don't we hear more about a "self-help"
movement in the news?

FR: One of the strengths of this movement has been that these people are not
involved in politics. In fact AA with its tradition of anonymity is expressly
anti-political, at least in name. That's not to say it hasn't been tried. SOAR
was a group that tried to lobby for government funding for alcohol treatment. it
didn't get membership because it was perceived by self-helpers as too political.

EB: The conventional wisdom about self-help groups is that they encourage people
to focus on themselves, numb them to collective action and encourage them to
stay home and mind their own business on election day.

FR: I don't think so. There's a study by Robert Wuthnow which showed that people
in small groups actually become more engaged in civic issues, not less, as a
result of participating in some sort of small group meeting. That tells you
something about the indirect effects of face-to-face meetings on civil society.
You have to consider the ethos of a small group.

EB: Ethos?

FR: Ethos is my word for the spirit, or the values that develop in a mutual aid
group. Part of the ethos is helping others like yourself, "giving back."

EB: Like giving back to the neighborhood. Is it just mutual aid and community
self-help that develop the ethos?

FR: More so in these forms, less in individual self-help. There's the
"barn-raising" ethos, revitalize the neighborhood, plant trees, etc. Then
there's the explicit anti-establishment, anti-external ethos. Even individual
self-help books sometimes encourage that.

EB: Do you think self-help books and gurus encourage too much "looking out for
number one?"

FR: There is certainly an individualist aspect to some of it, no doubt about it.
Bootstraps is the catch-all word: you know, pull yourself up by your bootstraps.
It's a much-exploited message. But you have to look at the behavior. Consider
the Nation of Islam...they go where no one else does, into prisons and housing
projects, showing there is more to self-help for them than individuals pulling
themselves up alone. More than an individualistic narrow focus. This is
spiritual, human beings at their best.

EB: Don't you consider some of their separatist rhetoric a little extreme?

FR: Yes, but on the other hand the very essence of self-help is exclusionary,
inside versus outside. Gangs are not self-help because they are hierarchical,
violating the democratic self-determined nature of self-help. The self-exclusion
of a group from society, like a cult, doesn't mean it is helping people.

EB: A lot of people would however say that self-help groups also may lead to a
"victimization" mentality. The guests on talk shows are told they have a problem
and then told to get help, either from therapy or a self-help group.

FR: No, that's wrong. Self-help says I didn't create the problem, but I'm
responsible for changing it. They don't buy the victim line at all. People like
Oprah commercialized the idea of being a victim. At first, she did a lot of
talking about problems and not much about solutions. Now even she has a
self-help message. Unfortunately she brings in a lot of gurus, too, and the
audience is often passive.

EB: Still there is a sense that the recovery movement, as it is sometimes
called, is disappointing compared with the large activist movements of the
1960s. How do you answer this?

FR: No question about it. It's a quieter form of social protest. The self-help
movement is non-confrontational with society. It's about little people,
underdogs and staying real. But the movement has changed a lot, I would say. It
does move slowly from small individual concerns to greater social problems, but
only I think when the individual realizes that there may be a societal
dysfunction partly to blame for their individual problems. That consciousness
takes time. But self-help does move to advocacy, think of Act-Up, Women's
Health, MADD, the Victim's Rights movement. They are certainly oriented toward
social change as well as their own internal goals. Many many elements of the
self-help movement are geared towards institutional change, health care, and
changes in the law. Disability rights for example. Sixties style
organizing--which I was a part of--was bigger, focused on changing a bad
society, stopping the war, changing social norms on free speech and sex, etc.

EB: Is there a limit to the non-judgmental nature of groups such as AA? There's
a sense that people are discouraged from criticism in these groups and that this
makes them wishy-washy citizens who wouldn't stand up for anything, because it's
all relative...

FR: Look, it depends on what you mean. Let's take the women's movement of the
1960s. The original consciousness-raising groups had strong self-help themes,
but it did not encourage passivity, quite the opposite.

EB: Well then, why wouldn't AA with its huge membership want to do something
about liquor advertising and or changing social attitudes towards heavy
drinking?

FR: For one thing it is against their tradition of anonymity in public life, a
cornerstone of the movement. It's rarely recognized that AA did significantly
change the public's attitude towards alcohol and alcoholics. Before AA
alcoholics were "bums." Individual members of AA have fought for alcohol
legislation. Senator Huges of Iowa for example. Many counselors, therapists and
activists came out of AA. plus it sparked groups that do take political action.
You have to look hard for the social dimension, but it is there.

EB: You've been in various self-help groups, most recently for Parkinson's
disease. How have your experiences been shaped by them?

FR: Tremendously. In a health-related group like the Parkinson's group, we were
all at various stages of the illness. I still remember before my symptoms were
serious, there was a man in the group who was at the stage I am at now. I have
been able to prepare each step of the way because of that experience. I also
learned some of the practical nitty-gritty from the group, where to buy special
velcro shoes, a motorized chair and so on...

EB: You speak a lot about involving self-help more closely in the human
services, what do you mean by that?

FR: Well I think the human service system badly needs some of the principles
that work so well for self-help: empowerment, self-reliance and
self-determination. The human service and health system are too dependent on
providing external fixes to "people in need." They never even think to emphasize
what people can do for themselves, and find ways to help them do it. There are a
lot of reasons for that: professionals have access to a certain knowledge and
training that makes them experts. On the other hand doesn't the non-professional
know a bit more about how it feels to have a condition? Isn't he also an
"expert" in some ways? This is the problem that has to be resolved if
self-helpers and the professional human service system are to work together. It
could revolutionize our treatment of social problems, but it won't be easy...